POS1187-HPR PARTICIPANTS’ VIEW ON THE FEASIBILITY OF INSELMA - A NEW INTERDISCIPLINARY NURSE-COORDINATED SELF-MANAGEMENT INTERVENTION TO PEOPLE WITH INFLAMMATORY ARTHRITIS AND SUBSTANTIAL DISEASE IMPACT - A QUALITATIVE EVALUATION
Authors: N. Blum, B. A. Esbensen, M. Østergaard, A. Bremander, O. Hendricks, L. Lindgren, L. Andersen, K. V. Jensen, J. Primdahl
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Despite continuous improvements in antirheumatic pharmacological treatment, many people with inflammatory arthritis (IA) still report substantial disease impact. Based on the framework for complex interventions [1], we developed a self-management intervention (INSELMA)[2]. Based on shared decision-making, which included an initial assessment and a goal setting process a rheumatology nurse coordinated interdisciplinary support and available offers in primary care to achieve the patients' individual goals. A feasibility test of the six-month intervention encompassed 19 patients with IA and substantial impact of the disease. <h3>Objectives</h3> The objective of this study was to explore the participants' experience of feasibility, acceptability, and potential benefit from participation in the INSELMA intervention. <h3>Methods</h3> Individual semi-structured interviews were conducted with participants in INSELMA. Thematic analysis was applied [3]. <h3>Results</h3> Fifteen participants were interviewed (9 women, 6 men, aged 44-75, 17-75 min.). The participants associated the benefits they experienced from the intervention to the impact IA had on their everyday lives. The analysis derived four overall themes. 1) <i>A new opportunity</i>. Participation in INSELMA was experienced as an opportunity to improve, reduce challenges, or change issues they felt they had fought alone until now. Some expressed worries that their situation was too complex to be able to contribute to the study and some participated to contribute to scientific IA evidence. 2) <i>The importance of person-centred goals</i>. The individual goals encompassed both physical, social, and emotional life skills. When expectations and goals were aligned, it facilitated a positive outcome. The empathic support and coaching from the nurses, who listened, motivated, and understood their problems were considered especially valuable. Time between consultations to work with goals at home was pointed out as important to experience progress. 3) <i>A little nudging means everything.</i> Several participants expressed that the intervention had contributed with new or refreshed knowledge and motivation to change habits. Some would like continued follow-up with the nurse after the end of the study to stay committed. Also some suggested that this type of intervention should be a general offer for all patients with IA. Having access to a physiotherapist and an occupational therapist with rheumatology experience for exercise support adapted to the participants' needs and abilities was especially important for them. 4) <i>I got more than I wished for</i>. The intervention was experienced as feasible and meaningful, and the overall impression was positive. Several cried tears of joy and gratitude as they experienced decreased symptom load, improvement in physical strength, mobility, and sleep as well as increased energy and coping. Two had experienced no change, of which one had resumed physical activity after several years. The participants expressed hope for the future as they had new tools and habits to prevent problems and manage symptoms, which resulted in motivation to work towards new goals. <h3>Conclusion</h3> Patients found the INSELMA intervention feasible. They experienced decreased disease impact and increased activity level, facilitated by empathy and self-management support from the health professionals. <h3>References</h3> [1] DOI: 10.1136/bmj.n2061 [2] DOI: dx.doi.org/10.1136/annrheumdis-2022-eular.984 [3] DOI: 10.1191/1478088706qp063oa <h3>Acknowledgements</h3> The authors thank the participants for generously sharing their experiences. <h3>Disclosure of Interests</h3> None Declared.